胃癌患者癌组织K-ras的表达及临床意义
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摘要
目的研究胃癌患者癌组织中K-ras表达水平及其临床意义。方法选取2016年1月—2018年1月我院进行手术治疗并经病理检查证实的胃癌患者120例,应用免疫组织化学染色法检测患者癌组织及癌旁组织中K-ras蛋白阳性表达情况;分析胃癌患者临床资料,探寻胃癌组织K-ras蛋白阳性表达的影响因素;观察胃癌组织中K-ras基因第12密码子点突变结果。结果胃癌组织K-ras蛋白阳性表达率高于癌旁组织,差异有统计学意义(P<0.01);logistic多因素回归分析发现,淋巴转移、组织分化程度低、病理分期晚是胃癌患者癌组织K-ras蛋白阳性表达的独立危险因素;胃癌组织K-ras基因第12密码子点突变率为8.33%(10/120),癌旁组织中未见突变。结论胃癌组织中K-ras蛋白阳性表达率高于癌旁组织,且淋巴转移、组织分化程度低、病理分期晚的胃癌患者癌组织中K-ras蛋白阳性表达水平高;K-ras突变在胃癌的发展中无主导作用,但可辅助评估患者预后,为靶向药物的选择提供参考。
Objective To study the expression level of K-ras in cancer tissues of patients with gastric cancer and its clinical significance. Methods A total of 120 patients who underwent surgery and were confirmed as gastric cancer by pathological examination in our hospital from January 2016 to January 2018 were selected. Immunohistochemistry was used to detect the positive expression of K-ras protein in cancer tissues and adjacent normal tissues. The clinical data of gastric cancer patients were analyzed, and the influencing factors of positive expression of K-ras protein in gastric cancer tissues were explored. The results of point mutation of K-ras gene 12 th codon in gastric cancer tissues were observed. Results The positive expression rate of K-ras protein in gastric cancer tissues was higher than that in adjacent normal tissues, with significant difference(P<0.01). Multivariate logistic regression analysis found that lymphatic metastasis, low tissue differentiation and advanced pathological stage were independent factors affecting the positive expression of K-ras protein in gastric cancer tissues. The mutation rate of K-ras 12 th codon in gastric cancer tissues was 8.33%(10/120), and there were no mutations in adjacent normal tissues. Conclusion The positive expression rate of K-ras protein in gastric cancer tissues is higher than that in adjacent normal tissues, and the positive expression level of K-ras protein is high in gastric cancer tissues of patients with lymphatic metastasis, low tissue differentiation and advanced pathological stage. K-ras mutation plays no dominant role in the development of gastric cancer, however, can help assess the prognosis of patients and provide a reference for the selection of targeted drugs.
Objective To study the expression level of K-ras in cancer tissues of patients with gastric cancer and its clinical significance. Methods A total of 120 patients who underwent surgery and were confirmed as gastric cancer by pathological examination in our hospital from January 2016 to January 2018 were selected. Immunohistochemistry was used to detect the positive expression of K-ras protein in cancer tissues and adjacent normal tissues. The clinical data of gastric cancer patients were analyzed, and the influencing factors of positive expression of K-ras protein in gastric cancer tissues were explored. The results of point mutation of K-ras gene 12 th codon in gastric cancer tissues were observed. Results The positive expression rate of K-ras protein in gastric cancer tissues was higher than that in adjacent normal tissues, with significant difference(P<0.01). Multivariate logistic regression analysis found that lymphatic metastasis, low tissue differentiation and advanced pathological stage were independent factors affecting the positive expression of K-ras protein in gastric cancer tissues. The mutation rate of K-ras 12 th codon in gastric cancer tissues was 8.33%(10/120), and there were no mutations in adjacent normal tissues. Conclusion The positive expression rate of K-ras protein in gastric cancer tissues is higher than that in adjacent normal tissues, and the positive expression level of K-ras protein is high in gastric cancer tissues of patients with lymphatic metastasis, low tissue differentiation and advanced pathological stage. K-ras mutation plays no dominant role in the development of gastric cancer, however, can help assess the prognosis of patients and provide a reference for the selection of targeted drugs.
引文
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[14] 王珊,董丽儒,任会强,等.肺腺癌中PD-1、PD-L1蛋白表达与K-RAS基因突变状态的相关性分析[J].临床与实验病理学杂志,2017,33(7):754-758.
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[2] 练英妮,毛进星,曾志坚,等.XELOX和OLF化疗方案治疗基因突变型老年晚期大肠癌的疗效分析[J].中国现代医学杂志,2016,26(2):51-54.
[3] 宋红林.血清糖链抗原、粘附分子及K-ras基因突变水平在胰腺癌中的表达及其临床意义[J].实用癌症杂志,2017,32(7):1105-1109.
[4] 杨斌凤,王仰坤,王苏南,等.胃癌组织中HER-2基因扩增和K-ras基因突变的关系[J].临床与实验病理学杂志,2016,32(6):615-619.
[5] 李国新.中国腹腔镜胃癌外科临床研究现状[J].中华消化外科杂志,2016,15(1):27-30.
[6] 左婷婷,郑荣寿,曾红梅,等.中国胃癌流行病学现状[J].中国肿瘤临床,2017,44(1):52-58.
[7] 崔飞博,陈南征,郑见宝,等.结直肠癌组织中EGFR、BRAF和K-RasK-Ras基因的表达及其临床意义[J].中国普外基础与临床杂志,2016,23(5):556-560.
[8] 张宇,卫子然,杨德君,等.Ras相关区域家族10蛋白在胃癌中的表达及其临床意义[J].第二军医大学学报,2016,37(5):590-594.
[9] 刘海青,施晓,杜玲,等.癌基因K-ras及C-Myc在宫颈癌中的表达及临床意义[J].中国妇幼保健,2017,32(9):2007-2010.
[10] 孟加榕,唐忠辉,温路生,等.K-ras、Livin在不同胃黏膜病变中的表达及临床意义[J].山西医科大学学报,2016,47(8):742-746.
[11] 于园园,李淑璟,刘新兰,等.胃癌组织中RASSF6和K-RAS的表达及其临床意义[J].宁夏医科大学学报,2017,39(9):998-1002,封2.
[12] 周昱,廉奇鑫,王新.CHD5及K-ras蛋白在大肠癌组织中的表达[J].黑龙江医药科学,2016,39(2):39-41.
[13] 熊秋迎,熊欣,胡秀华,等.K-ras基因状态及ras蛋白表达在胃印戒细胞癌免疫表型分类中的意义[J].重庆医学,2017,46(15):2027-2029,2033.
[14] 王珊,董丽儒,任会强,等.肺腺癌中PD-1、PD-L1蛋白表达与K-RAS基因突变状态的相关性分析[J].临床与实验病理学杂志,2017,33(7):754-758.
[15] 黄荧,魏嘉,刘宝瑞.K-ras突变在胃癌预后及靶向治疗中的研究进展[J].中华肿瘤杂志,2016,38(2):81-85.